Published by The Ambulance Victoria Office of the Medical Director
Health & Fitness
Medicine
The podcast for paramedics and anyone involved in out-of-hospital care that is critical, urgent, or unplanned. Hosted by James Oswald (Paramedic and clinical guideline developer) and A/Prof David Anderson (Medical Director).Keyword: Paramedic, paramedicine, Emergency Medical Service, EMS, Emergency Medical Technician, EMT, prehospital, pre-hospital critical care, retrieval medicine, ambulance, Helicopter Emergency Medical Service, HEMS, air ambulance, emergency, first responder, first aid.
Can a machine diagnose, triage, document a case, or show empathy? AI is everywhere and the pace of change makes it difficult to know when to stop and take stock. In this episode, we explain how AI works for clinicians, what the evidence shows, what the risks and benefits are in healthcare, and what it means for our clinical practice. Disclaimer: While we did our best to ensure the content was accurate, we don’t script everything and sometimes we do make mistakes. If you hear something in this episode that you disagree with, we want to hear from you, so please get in touch. Further resources AI-Assisted Decision Trees for Emergency Call Classification: The IAppel Project | Springer Nature Link Transforming Health Care Through Chatbots for Medical History-Taking and Future Directions: Comprehensive Systematic Review - PubMed Clinical Reasoning of a Generative Artificial Intelligence Model Compared With Physicians - PMC A systematic review and meta-analysis of diagnostic performance comparison between generative AI and physicians - PubMed Large Language Model Influence on Diagnostic Reasoning: A Randomized Clinical Trial Assessing the potential of GPT-4 to perpetuate racial and gender biases in health care: a model evaluation study Comparing ambient scribes: a randomized crossover clinical trial addressing ambient scribe technologies’ impact on physician burnout Ambient AI Scribes in Clinical Practice: A Randomized Trial Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations Producer: Liam Mylebry
Clinical Update: June 2026
Your monthly clinical update covering: · Clinical Practice Update: Forthcoming CPG changes including AF referral pathways, low‑risk chest pain risk scoring, and paediatric gastro guideline Ebola bulletin and CHO advisory Cardiac Arrest Team Performance Report: insights and practical takeaways for improving CPR quality PANDA trial update · Patient safety update: Non-transport decisions, assessment, trusting our equipment · Paper of the month: Naloxone and Clinical Outcomes in Suspected Opioid-Associated Out-of-Hospital Cardiac Arrests | Emergency Medicine | JAMA Network Open | JAMA Network Naloxone for Out-of-Hospital Cardiac Arrest Due to Opioid Toxicity | Emergency Medicine | JAMA Network Open | JAMA Network · Equipment update: Hypothermia, auxiliary purchase list updates, and giving sets · Professional development opportunities: Expression of Interest - 2026 CAA Congress Attendance Grand Round | 23 June 2026 · Small steps to improve your practice ======= Get in touch clinicalguidelines@ambulance.vic.gov.au Linkedin James Ben Producer: Liam Mylebry
Clinical Updates: May 2026
Your monthly clinical update covering: · CPG updates: New measles CPG + updated CPP for ACOs & CERTs · Hand hygiene refresher: Back to basics in challenging environments · Cardiac arrest outcomes: Conversation with Ziad Nehme on recent improvements · Survey plug: Clinical & Operational Service Delivery Plan · Patient safety: Case review – consulting via the Clinician when engaging external agencies (e.g. PIPER) · Tourniquets: Balancing risks and benefits · Paper of the month: Ambulance offload delays and causes of ramping · Equipment update · Professional development highlights · Small steps: Practical changes to transform your practice ======= CPG update : CPG update – April 2026 VOD update : Updated guidance - Requests for Verification of Death (VOD) Hand hygiene : Take Five for Hand Hygiene Transmission based precautions clinical work instruction CWI OPS 184 Infection Prevention and Control Transmission Based Precautions.pdf Paper of the month: Initiatives to reduce ambulance offload delays in emergency departments: a scoping review - PubMed Professional development: Fast Tracked Higher Education Pathway for AV Clinical Instructors – Now Open for Mid-Year Intake Clinical Insights: Issue 8 now available The Australasian College of Paramedicine Conference | ACPIC26 CAA Congress | The Council of Ambulance Authorities Inc. Trauma 2026 Conference - Trauma Conference SAS Events – Safe Airway Society Clinical Technology and Equipment Committee Idea Sharing : Clinical Technology and Equipment Committee / CTEC@ambulance.vic.gov.au Get in touch: clinicalguidelines@ambulance.vic.gov.au Linkedin James Ben Producer
Clinical Updates: March 2026
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). This month's episode covers: Planned updates to CPGs in 2026 Posterior Stroke Patient Care Records Evaluation data of droperidol and dexamethasone as antiemetics Paper of the Month: IV vs IO in cardiac arrest Equipment update Professional development opportunities Small steps to transform your practice Paper of the Month Vascular access by paramedics during cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A retrospective study of insertion success rates and survival outcomes of intravenous versus intraosseous route https://www.sciencedirect.com/science/article/abs/pii/S0735675726000628 Professional Development Opportunities The Australasian College of Paramedicine | Primary Care Conference 2026 ACP 2026 Education Grants: 2026 Education Grants Open Posterior Stroke Not so FAST: pre-hospital posterior circulation stroke - PMC Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter James: @JamesOz1 Ben: @ben_meadley Linkedin James Ben Producer: Liam Hennebry
Paramedics DO diagnose: diagnostic safety with A/Professor Carmel Crock
In this episode of Clinical Conversations , we're joined by Associate Professor Carmel Crock (Director of the Emergency Department at the Royal Victorian Eye and Ear Hospital and Chair of the Quality & Patient Safety Committee at the Australasian College of Emergency Medicine) to unpack what diagnosis is, how diagnostic error happens, and how we can make diagnosis safer. We explore common pitfalls like premature closure and diagnostic momentum, and practical ways to improve diagnostic safety. Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations Producer: Liam Hennebry
Clinical Updates: February 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Cardiac Arrest Update with AV Resuscitation Coordinator Steve Musgrave Patient Safety Update: Stroke Assessment and Elderly Falls Alpine and Wilderness Response Alagaesia Toxicology Evaluation Alcohol Withdrawal Guideline Equipment Update: Syringe Drivers Paper of the Month Prehospital transesophageal echocardiography versus conventional advanced life support in out-of-hospital cardiac arrest (PHTEE–OHCA) – a randomized controlled pilot study: https://link.springer.com/article/10.1186/s13054-025-05805-w Professional Development Opportunities Fast-Tracked Higher Education Pathway for AV Clinical Instructors: https://ambulancevic.sharepoint.com/sites/OneAV-news-and-updates/SitePages/Exciting-Opportunity-Fast-Tracked-Higher-Education-Pathway-for-AV-Clinical-Instructors.aspx?web=1 ACP Primary Care Conference Canberra: 21-22 May ACPIC Melbourne : 8-11 September EMS Asia Singapore 7-13 November Grad Cert MH: https://victoriauniversity.online/ppc/graduate-certificate-mental-health https://www.latrobe.edu.au/courses/graduate-certificate-in-mental-health#/overview?location=ON&studentType=dom&year=2026 https://online.scu.edu.au/online-courses/graduate-certificate-mental-health https://handbook.monash.edu/2024/courses/m4039 AICG: Clinical Governance, Effective Leadership, Clinical Education, Clinical Feedback. https://www.aicg.edu.au/education/online-courses/ Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter James: @JamesOz1 Ben: @ben_meadley Linkedin James Ben Producer: Liam Hennebry
Non-Invasive Ventilation (CPAP and BiPAP)
In this episode of Clinical Conversations , James Oswald and Ambulance Victoria Medical Director Dr David Anderson unpack non-invasive ventilation (NIV) for prehospital care. They explain the key physiology ( oxygenation vs ventilation ), the practical difference between CPAP and BiPAP , and how this guides use in COPD, acute pulmonary oedema, COVID, asthma , and undifferentiated dyspnoea . The discussion also covers patient coaching, mask fit troubleshooting, essential monitoring, and how to recognise early success vs failure —including when to escalate and call for help. Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations Producer: Liam Hennebry
Clinical Updates: December 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Hear from Louise Reynolds (Victoria’s Chief Paramedic Officer) on the women’s pain inquiry findings—and what it means for paramedic practice. Spotlight the VVED back pain pathway: for many patients, opioids + ED isn’t the answer—community physio support can be surprisingly effective. Adam Ho (AV Senior Pharmacist) answers the most common medication questions. Paper of the Month: a must-read on post-intubation hypotension. Ben runs through key professional development opportunities for 2025 and what’s coming in 2026. Equipment update. And we wrap with small steps to transform your practice Further resources VVED Back pain pathway presentation (AV employees only): https://engage.cloud.microsoft/main/threads/eyJfdHlwZSI6IlRocmVhZCIsImlkIjoiMzU5OTQ5NzU4NzMzNTE2OCJ9?trk_copy_link=V1 AI Professional Development Courses Free micro-skill course in AI: https://www.australianindustrygroup.com.au/education-training/centre-for-education-and-training/blog/free-introduction-to-artificial-intelligence-microskill-course Digital health 101: https://digitalhealthworkforce.org.au/education-and-resources/ Australian Institute of Digital Health AI essentials: https://cpd.digitalhealth.org.au/course/ai-essentials AI Podcasts NEJM AI Grand rounds (AI Podcast): https://store.nejm.org/signup/ai/podcasts Beyond the prompt (AI podcast): https://www.beyondtheprompt.ai/ Paper of the month Prehospital Postintubation Hypotension and Survival in Severe Traumatic Brain Injury: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2841682 Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults: https://www.nejm.org/doi/abs/10.1056/NEJMoa2511420 Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter James: @JamesOz1 Ben: @ben_meadley Linkedin James Ben Producer: Liam Hennebry
Clinical Conversations: Medical Director Live Q&A
In our first ever live episode of Clinical Conversations , James Oswald (CPG specialist and paramedic) is joined by Ambulance Victoria Medical Director Dr David Anderson for an end-of-year Q&A on the latest CPG updates. We work through staff questions on the “why” behind key changes—including respiratory care and oxygen targets, NIV expansion and mask issues, airway and RSI updates (including crash induction and consultation for single-responder MICA), and several medication updates such as magnesium compatibility, levetiracetam after midazolam, IV GTN in APO, and opioid choice and multimodal analgesia. They also cover practical operational issues like VVED wait times and what to do when access delays are affecting crews. Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations
Clinical Updates: November 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 02:10 – CPG Update Released • Highlights major 2025 CPG changes, app issues, and expected three-month transition period (IFS ceases immediately). • Emphasis on professional judgment, understanding over memorisation, and upcoming live Q&A. • Request for staff feedback on new learning methods. 05:42 – Women’s Pain Inquiry Findings • Large Victorian inquiry confirms women’s pain is frequently dismissed; implications for paramedic practice. 06:58 – Registration & Professional Capabilities • Registration season brings opportunity to review Paramedicine Board capabilities: communication, cultural safety, risk management, lifelong learning. 08:05 – Paper 1: AI ECG for STEMI • AI ECG analysis outperforms clinicians in complex cases and may reduce cath lab false activations; human–AI collaboration is the future. 10:20 – Paper 2: Community Paramedicine Study • Time-and-motion study shows community paramedicine is a thinking-intensive role with few interventions. 13:40 – Paper 3: Methoxy vs Fentanyl vs Morphine • Methoxyfluorane provides fastest early analgesia; supports multimodal pain management with methoxy as a strong first-line option. 17:56 – Equipment Update • Reminder not to pre-connect sensitive devices (e.g., EtCO₂ adapters, Yankauer) due to temperature and contamination risks. 19:54 – AI Professional Development Workshop • Upcoming Monash workshop on trustworthy generative AI for healthcare, available in-person and virtually. Resources Inquiry into women’s pain: https://www.health.vic.gov.au/inquiry-into-womens-pain Gender disparities in EMS care: https://pubmed.ncbi.nlm.nih.gov/36369725/ Sex Differences in Patients With Acute Chest Pain: https://www.sciencedirect.com/science/article/pii/S0735109723000839 Professional capabilities: https://www.paramedicineboard.gov.au/Professional-standards/Professional-capabilities-for-registered-paramedics.aspx Papers of the month Community paramedicine: https://www.sciencedirect.com/science/article/pii/S2588994X25000909?via%3Dihub Pain relief study: https://www.sciencedirect.com/science/article/abs/pii/S0140673625015752 AI-Enabled ECG Analysis: https://www.jacc.org/doi/10.1016/j.jcin.2025.10.018 Professional development Building Trustworthy GenAI for Healthcare Innovation: https://shop.monash.edu/masterclass-building-trustworthy-genai-for-healthcare-innovation.html Get in touch clinicalguidelines@ambulance.vic.gov.au James: https://linktr.ee/ClinicalConversations Ben: @ben_meadley , Ben - Linkedin Producer: Liam Hennebry
Clinical Updates: October 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 01:40 – 2025 Clinical Update Coming Soon 02:20 – IFS Retirement & Paediatric RSI Feedback 07:05 – STEMI Performance Update 08:50 – Free Birth: Paramedic Implications 11:50 – PANDA Trial Update 13:50 – Patient Safety: Cognitive bias & discounting concerning symptoms 19:20 – Missing PCRs in Severe Adverse Events 21:50 – Guideline Monitoring: Minor Head Injury & VVED Outcome Data 22:50 – Paper of the Month & New Cardiac Arrest Guidelines 25:45 – Equipment Updates 26:59 – Professional Development Opportunities 28:15 – Small Steps to Transform Your Practice Further resources Freebirth - Position statement | Safer Care Victoria EMCRIT episode on paediatric FONA: https://emcrit.org/emcrit/pediatric-tracheotomy/ ERC 2025 Guidelines: https://www.erc.edu/science-research/guidelines/guidelines-2025/guidelines-2025-english/ AHA 2025 Guidelines: https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines Opinion piece - Iain Beardsell: https://www.bmj.com/content/390/bmj.r2051 ACP Regional Paramedic Symposium: https://paramedics.org/events/rps-2025?tab=About Emergency, Trauma & Critical Care Conference: https://www.fltr-ed.com/ Get in touch X / Twitter / Bluesky James: @JamesOz1 | @jamesoz1.bsky.social Ben: @ben_meadley Linkedin James Ben Producer: Liam Hennebry
Clinical Updates: Paediatic intubation special
James Oswald is joined by an expert panel to discuss the background, evidence and rationale behind the retirement of intubation facilitated by sedation: Richard Armour – MICA paramedic, PhD candidate, CPG specialist. Dr Claire Wilkin – PEM, AV Medical Advisor - Paediatrics A/Prof David Anderson – AV Medical Director Get in touch clinicalguidelines@ambulance.vic.gov.au David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations
Clinical Updates: September 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): Clinical Update Warm IV fluid (13:38): Stop warming IV fluids in overhead compartments or with hot water bottles. Risks scalding/superheating. Store in equipment towers only. Paediatric distraction (03:26): kits available now. Evidence-based, non-digital active tools work best. Order via iProc. Document use in VACIS. Paediatric NIV (9:20): pathways with RCH/Monash/PIPER. Use patient device if feasible; alternatives include Flow-Safe and Zoll Z-Vent. More guidance coming. Patient safety Low acuity, high risk (12:32): Some high-risk patients sit in apparently low acuity cases. Advocate, self-upgrade when risk warrants. Lodge cases in RiskMan. Standing height falls (14:49): Standing-height falls in older adults: great feedback from the field, we discuss common themes. Paper of the Month (19:26): measurable “hyperacute T-wave” definition predicts OMI even without STEMI criteria. Equipment (21:40): new neonatal BVMs; syringe-holder prototypes to separate RSI meds. CPD (24:21): short courses and LinkedIn Learning suggestions. Further resources Occlusion myocardial infarction and artificial intelligence Hyperacute T-wave definition https://journals.sagepub.com/doi/full/10.1177/27536386251371078 https://shortcourses.rmit.edu.au/collections/all https://mbs.edu/short-courses https://www.monash.edu/business/corporate-education/short-courses Linkedin.com/learning/ Get in touch James: https://linktr.ee/ClinicalConversations Ben: X/Twitter | Linkedin clinicalguidelines@ambulance.vic.gov.au
Cardiogenic shock
This month James and David look at cardiogenic shock: recognition and classification, oxygen targets, fluid resuscitation, vasopressors, inotropes, and the possibility of shock centres in the future. They're joined by Professor Dion Stub, an interventional cardiologist, prolific researcher, professor at Monash University, member of the Australian Resuscitation Council, and medical advisor to Ambulance Victoria. Further resources Avoid trial: https://www.ahajournals.org/doi/10.1161/circulationaha.114.014494 DETO2XAMI: https://www.nejm.org/doi/full/10.1056/NEJMoa1706222#:~:text=The%20Determination%20of%20the%20Role,not%20have%20hypoxemia%20at%20baseline . EXACT pilot trial: Concerns regarding the safety of prehospital titrated oxygen in post-cardiac arrest patients https://pubmed.ncbi.nlm.nih.gov/29684433/ PANDA Trial (AV Staff) https://ambulancevic.sharepoint.com/sites/OneAVQualityandClinicalInnovation/SitePages/PANDA-TRIAL-(.aspx Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations
Clinical Updates: August 2025
Your monthly clinical update covering: Mandatory VVED Consults for Infants <28 Days – trends, rationale for policy, clarifications, and case example demonstrating impact. Stroke updates - performing ACT-FAST on all MASS positive patients, changes to VACIS and a plug for IV access. Complex Paediatric Respiratory Patients – Managing patients on home non-invasive ventilation, maintaining continuity of care, and upcoming resources. Trauma Updates – Blood component therapy expansion and compliance requirements. STAB-5 mnemonic and minimising scene time in major trauma. PANDA trial enrolment reminder. Standing-Height Falls in Elderly – Missed spinal injury cases, cultural pendulum shift, guideline review, and call for feedback. Manual Handling & Patient Safety in ED Cohorting – Safe movement of high-risk patients and preventing deterioration during cohorting. Paper of the Month – Danish machine learning study outperforming NEWS2 for predicting deterioration from first-five-minute vitals, with explainable AI. Equipment Committee Updates – New traction splints, medication safety devices via 3D printing, thermal blanket effectiveness, and syringe driver software updates. Professional Development & Resources – Coroner’s Communiques, ACP International Conference, new paramedic podcasts. Small Steps to Transform Practice – Treat elderly standing-height falls as potential spinal injuries. Minimise scene time for major trauma unless safety or critical intervention requires it. Further resources ACP Conference Thermal blanket study Machine learning study STAB-5 Coroner's communique Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter / Bluesky James: @JamesOz1 | @jamesoz1.bsky.social Ben: @ben_meadley Linkedin James Ben
Q&A: Sedation, trauma, why we need to change and the future of paramedicine.
In this special Q&A episode of Clinical Conversations , James Oswald and Dr. David Anderson respond to the most common — and most complex — questions we've received on sedation, CPG implementation, and the evolving role of paramedics. We also reflect on why clinical guidelines are becoming more detailed, how to balance complexity with emergency care, and what the future holds for paramedics. Get in touch clinicalguidelines@ambulance.vic.gov.au Socials David: @expensivecare | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations | LinkedIn
Clinical Updates: July 2025
Your monthly update on clinical issues including: Clinical Practice Care and Control Powers (02:38 – 07:10) Overview of section 232 and 241 powers. Documentation: VACIS + RiskMan entries are essential. More info: See Mental Health Crisis Reform on OneAV. Verification of Death (07:10 – 08:48) Verifying death is voluntary for paramedics. Review WinOps 025 for current processes. AV is working with VicPol to improve processes. Encourage local discussion with TM/CSO about your approach. Resus Ready Campaign (08:48 –10:34) Aims to boost preparedness for cardiac arrest. Includes: equipment checks, airway readiness, skills rehearsal. Backed by patient safety reviews and cardiac arrest strategy. Goal: Ensure every paramedic is ready regardless of experience/frequency. Case 1 : Pediatric respiratory case attended with only adult equipment. Reflect on the potential trajectory of cases with reference to the balance of between taking all equipment vs minimising manual handling risk Case 2 : Chest rise/fall insufficient alone to assess ventilation. Use waveform capnography early and consistently. Case 3 : CO₂ of 6mmHg was the only clue of incorrect tube placement in intubated asthma patient. Always consider full clinical picture and question if data doesn’t make sense. Paper of the month (14:46 – 20:55) Parental Concern in Pediatric Deterioration Asking "Are you worried your child is getting worse?" adds predictive value. Parents who said “yes” had children: 4x more likely to go to ICU/be ventilated. More likely to be admitted or have longer stays. Concern was a stronger predictor than abnormal vital signs. Recommendation: Make carer concern an active, routine part of pediatric assessment. Equipment Update (20:55 – 22:55) New absorbent transfer sheet ("large bluey") improves: Patient hygiene and comfort. Paramedic safety. Part of AV's broader equipment strategy under new Clinical Technology & Equipment Committee . Professional Development: Postgraduate Study (22:55 – 24:59) Encouragement for paramedics to pursue study outside paramedicine: Public health, digital health, systems leadership, etc. Builds capability to: Lead teams, influence policy, improve care. Resource guide in show notes; feedback encouraged. Small Steps to Transform Practice (24:59 – 26:42) Ben’s tip: Don’t rely on chest rise alone—use capnography toassess ventilation. James’s tip: Proactively ask parents if they’re worried their child is deteriorating. Resources Association between caregiver concern for clinicaldeterioration and critical illness in children presenting to hospital: a prospective cohort study https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(25)00098-7/abstract Clinical Technology andEquipment Committee https://ambulancevic.sharepoint.com/sites/OneAV-resource-hub/_layouts/15/viewer.aspx?sourcedoc={1633f009-99d3-4d08-9805-d5fb409fec3b }
Paediatric acute behavioural disturbance
In this episode of Clinical Conversations , we explore the complexities of managing acute behavioural disturbance (ABD) in children and adolescents—a small but increasingly common and high-risk cohort. Host James Oswald and AV Medical Director Dr. David Anderson are joined by paediatric emergency physician Dr. Claire Wilkin, who brings deep expertise in paediatric critical care. Together, they discuss the causes of ABD in younger patients, differences from adult presentations, principles of de-escalation, the role of sedation, and how to assess and manage risk. Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter / Blusky David: @expensivecare | @expensivecare.bsky.social James: @JamesOz1 | Linkedin James David
Clinical Update
Your monthly clinical update covering: Clinical Practice 03:10 – Respiratory CPG Update: Pulmonary edema, COVID, ILI, paediatric asthma changes coming soon. 04:00 – First Responder Analgesia: Supply challenges beingaddressed; updates coming. 05:10 – Button Batteries: New blue dye marker—importantvisual sign but not universally present. 06:00 – Mushroom Season Warning: Watch for toxidromes; VPIC support emphasized. 06:40 – VVED changes: Easier access to emergency physicians. Patient Safety 08:30 Case: Declined transport with adverse outcome. Consent must be truly informed—document clearly, especially under cognitive load or red flags. Guideline monitoring 11:15 Sedation Safety Update: Improved safety with guidelinechanges. Case Reports & Engagement 13:10 Case reports welcome—CPG team happy to assist. Paper of the month 13:40 Comparison of demand valve vs. standard BVM. No differencein oxygenation delivery in healthy volunteers. Nasal prongs speed time to oxygenation saturation. Continue using both tools in RSI prep. New ACS Guidelines Summary (ft. Andrew Bishop) (18:30) ACOMI terminology replaces STEMI/Non-STEMI binary. Key ECG findings added. Serial ECGs every 10 mins; prehospital thrombolysis within 30mins. Equipment 23:50 Asset Numbers: Include in Riskman reports to aid faultresolution. Professional Development 24:30 AICG Highlight: Leadership training relevant across paramedicine—CPD eligible and recommended. Small Steps to Transform Practice 26:30 Get in touch X / Twitter / Bluesky James: @JamesOz1 | @jamesoz1.bsky.social Ben: @ben_meadley Linkedin James Ben
Paediatric assessment, consultation and virtual emergency care
James Oswald and Dr David Anderson explore how consultation has evolved from a perceived weakness to a hallmark of clinical maturity. They discuss the growing role of virtual emergency care, particularly the Victorian Virtual Emergency Department (VVED), in supporting paramedics with decision-making—especially when assessing young infants. Joined by pediatric emergency specialist Dr Harith Al-Rawi, the episode dives into the challenges of remote pediatric assessment, the value of collaboration between paramedics and virtual care clinicians, and the structured information required during remote consultation to safely support care at home. The conversation highlights that newborns are a uniquely high-risk group, and outlines why VVED consultation is now a must for infants aged 28 days or younger. Get in touch clinicalguidelines@ambulance.vic.gov.au X / Twitter / Blusky David: @expensivecare | @expensivecare.bsky.social James: @JamesOz1 Linkedin James David Producer: Liam Hennebry
